Provider Demographics
NPI:1174723712
Name:RAWSON, RICHARD ELMER (PSYD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ELMER
Last Name:RAWSON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9834 BEACH MILL RD
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:22066-3709
Mailing Address - Country:US
Mailing Address - Phone:703-599-1078
Mailing Address - Fax:703-991-9162
Practice Address - Street 1:491 CARLISLE DR STE B
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4895
Practice Address - Country:US
Practice Address - Phone:703-481-9369
Practice Address - Fax:703-991-9162
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810000377103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist